Coronary reserve and arteriolosclerosis in hypertensive heart disease

• Published in: Clinical research in cardiology 2000-01, Vol.89 Suppl 9, p.IX/132-IX135
• Main Authors: Schwartzkopff, B, Strauer, B E
• Format: Article
• Language: English
• Subjects: Animals; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - pharmacology; Antihypertensive Agents - therapeutic use; Antihypertensives; Arteries; Arterioles; Arterioles - pathology; Arterioles - physiopathology; Autonomic Nervous System - physiology; Blood Pressure; Cardiovascular disease; Cardiovascular diseases; Clinical Trials as Topic; Collagen; Coronary artery; Coronary artery disease; Coronary Circulation; Heart - drug effects; Heart - physiopathology; Heart diseases; Heart Diseases - etiology; Heart Diseases - physiopathology; Humans; Hypertension; Hypertension - complications; Hypertension - drug therapy; Hypertension - physiopathology; Hypertrophy; Ischemia; Microcirculation - physiology; Myocardial ischemia; Myocardium; Myocardium - metabolism; Oxygen - metabolism; Rats; Sclerosis; Stiffness; Structure-function relationships; Thickening; Time Factors; Vascular Resistance - physiology; Vasodilation; Ventricle
• ISSN: 0300-5860; 1861-0684; 1435-1285; 1861-0692
• DOI: 10.1007/s003920070019

Hypertensive heart disease leads to left ventricular hypertrophy, structural and functional alterations of the myocardium, and to wall thickening and sclerosis of intramural coronary arteries and arterioles, called arteriolosclerosis, that increase myocardial stiffness and cause diastolic dysfunction right from the beginning. Especially, increased content of collagen in the periarteriolar region contributes to impaired coronary reserve that predisposes to myocardial ischemia even in the absence of coronary artery disease and may be an important factor for diastolic and finally systolic dysfunction. Antihypertensive therapy should additionally aim at inducing repair of myocardial and vascular structure.